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Journal of Assisted Reproduction and Genetics
Published in: Journal of Assisted Reproduction and Genetics 11/2019

01-11-2019 | Infertility | Review

Premature ovarian insufficiency (POI) and autoimmunity-an update appraisal

Authors: Michal Kirshenbaum, Raoul Orvieto

Published in: Journal of Assisted Reproduction and Genetics | Issue 11/2019

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Abstract

Purpose

Primary ovarian insufficiency (POI) represents ovarian dysfunction related to very early aging of the ovaries. While the cause of POI in a majority of clinical cases remains undefined, autoimmunity is responsible for approximately 4–30% of POI cases. In the present paper, we aim to provide a critical appraisal and update review on the role of autoimmunity in POI patients.

Methods

A literature review was conducted for all relevant articles reporting on POI and autoimmunity. PubMed/MEDLINE and the Cochrane library were searched for the best available evidence on this topic.

Results

Patients with POI and coexisting autoimmunity are indistinguishable from those with negative autoimmune screen with regard to age of onset, prevalence of primary amenorrhea, or their endocrine profiles. A specific noninvasive reliable diagnostic test for the diagnosis of an autoimmune etiology is lacking; therefore, patients should be screened for the most common autoantibodies, i.e., steroid cell antibodies, anti-ovarian antibodies, and anti-thyroid antibodies. Moreover, treatment strategies to POI infertility are lacking and controversial.

Conclusions

Nowadays, guidelines for the treatment of autoimmune POI are not available. Moreover, since diagnostic and treatment strategies to POI infertility are still lacking and controversial, further large clinical studies are needed to investigate the true impact of autoimmunity on POI and to identify the selected groups of patients who are most likely to benefit from immunossuprresive treatment.
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Metadata
Title
Premature ovarian insufficiency (POI) and autoimmunity-an update appraisal
Authors
Michal Kirshenbaum
Raoul Orvieto
Publication date
01-11-2019
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 11/2019
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-019-01572-0

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